Economic Burden

Studies have shown that the global cost of rotavirus infections – including both outpatient visits and hospitalizations—exceeds $200 million each year.

Cost for Families and Households

The cost of hospitalizing a child for several days can be devastating to families, but even parents able to treat children in outpatient facilities can lose many hours of work. Costs to families typically include treatment, transportation, and missed wages.

  • In Libya, the average OOP expenses borne by families of patients treated at three urban public hospitals represented about 25% of a typical family’s monthly income when medical as well as other costs such as transportation were included1
  • In Malaysia, OOP payments for a rotavirus episode (mainly for hospital care) were considered catastrophic to 16% of families in the lowest income group (quintile) and 18% of families in the second poorest income group2.
  • In Vietnam, the mean number of working days lost due to rotavirus in a child (hospitalized and outpatient cases combined) was more than 9 days3.
  • In Sweden, lost wages of caretakers resulting from a child hospitalized with rotavirus averaged €1,621 (≈$1,800), making up 94% of the costs borne by households4.

Figure: Average Costs of Rotavirus Hospitalization to Families as a Percentage of National Monthly Household Income*(1, 5-7)

Cost for Countries and Health Systems

Rotavirus infections incur major direct hospitalization and out-patient costs to healthcare systems. Infections further cause major indirect costs to societies related to productivity losses, transportation, and accommodation during treatment.

  • In India, a 2014 study estimated that rotavirus hospitalizations cost about US$73 million each year, while outpatient treatments cost about US$80 millon8.
  • India spent an estimated $171 million treating rotavirus from birth to age 5 in a cohort of infants born in 20118.
  • For one cohort of children born in Iran, rotavirus infections over a 5-year period costs US $12 million from the healthcare perspective and US$32 million from the societal perspective9.
  • Kenya’s health care providers spent nearly $11 million in 2007, or $8.14 for every child under 5 on rotavirus treatment7.
  • Rotavirus treatment cost the healthcare system of Malaysia an estimated $33.5 million in 201310.
  • In Senegal, rotavirus disease is responsible for an estimated US$19 million in government healthcare service costs, and more than US$28 million in societal health service costs11.

Figure: Average Costs of Hospitalizations Due to Rotavirus Gastroenteritis

For more information, check out the Economic Costs of Rotavirus Disease and The Value of Vaccines brief.

References

1. Alkoshi, S., et al., Anticipating rotavirus vaccines-a pre-vaccine assessment of incidence and economic burden of rotavirus hospitalizations among children <5 year of age in Libya, 2012-13. BMC Public Health 2015, 15, 26.

2. Loganathan, T., et al., Rotavirus vaccines contribute towards universal health coverage in a mixed public-private healthcare system. Trop Med Int Health 2016, 21 (11), 1458-1467.

3. Riewpaiboon, A., et al., Cost of rotavirus diarrhea for programmatic evaluation of vaccination in Vietnam. BMC Public Health, 2016. 16(1): p. 777.

4. Tran, A. N., et al., Impact on affected families and society of severe rotavirus infections in Swedish children assessed in a prospective cohort study. Infect Dis (Lond) 2018, 50(5), 361-371.

5. Loganathan, T., et al., Household catastrophic healthcare expenditure and impoverishment due to rotavirus gastroenteritis requiring hospitalization in Malaysia. PLoS One 2015, 10 (5), e0125878.

6. Sigei, C., et al., Cost-effectiveness of rotavirus vaccination in Kenya and Ugadna. Vaccine 2015, 33 Suppl 1, A109-18.

7. Tate, J.E., et al., Rotavirus disease burden and impact and cost-effectiveness of a rotavirus vaccination program in Kenya. J Infect Dis 2009, 200 Suppl 1, S76-84.

8. John, J., et al., Rotavirus gastroenteritis in India, 2011-2013: revised estimates of disease burden and potential impact of vaccines. Vaccine, 2014. 32 Suppl 1: p.A5-9.

9. Mousavi Jarrahi, Y., et al., The cost effectiveness of rotavirus vaccination in Iran. Hum Vaccin Immunother, 2016. 12(3): p. 794-800.

10. Loganathan, T., et al., The Hidden Health and Economic Burden of Rotavirus Gastroenteritis in Malaysia: An Estimation Using Multiple Data Sources. Pediatr Infect Dis J 2016, 35 (6), 601-6.

11. Diop, A., et al., Estimated impact and cost-effectiveness of rotavirus vaccination in Senegal: A country-led analysis. Vaccine, 2015. 33 Suppl 1: p. A119-25.

12 Koksai, T., et al., Cost-effectiveness of rotavirus vaccination in Turkey. J Microbiol Immunol Infect 2017, 50 (5), 693-699.

13. Tam, C.C.; O’Brien, S. J., Economic Cost of Campylobacter, Norovirus and Rotavirus Disease in the United Kingdom. PLoS One 2016, 11 (2), e0138526.

14. Tichopad, A., et al., Cost Burden of Severe Community-Acquired Rotavirus Gastroenteritis Requiring Hospitalization in the Czech Republic, Slovakia, Poland, and Hungary: A Retrospective Patient Chart Review. Value Health Reg Issues 2016, 10, 53-60.

15. Aidelsburger, P., et al., Cost-effectiveness of childhood rotavirus vaccination in Germany. Vaccine 2014, 32 (17), 1964-74.

Sources
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The ROTA Council was created in collaboration with an advisory group of 24 child health leaders from around the world. We promote the use of rotavirus vaccines as part of a comprehensive approach to addressing diarrheal disease.

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